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HomeMy WebLinkAboutAgreement A-15-317-2 with Kings View.pdfCOUNTY OF FRESNO Fresno, CA -1 - 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 AMENDMENT II TO AGREEMENT THIS AMENDMENT, hereinafter referred to as “Amendment II”, is made and entered into this _____ day of _____________, 2020, by and between the COUNTY OF FRESNO, a Political Subdivision of the State of California, hereinafter referred to as “COUNTY”, and KINGS VIEW BEHAVIORAL HEALTH, whose address is 7170 North Financial Drive, Suite 110, Fresno, California, 93720, hereinafter referred to as “CONTRACTOR” (collectively as the “parties”). WHEREAS, the parties entered into that certain Agreement, identified as COUNTY Agreement No. 15-317, effective July 1, 2015, as amended by COUNTY Amendment No. 15-317-1, effective July 10, 2018, hereinafter collectively referred to as COUNTY Agreement No. 15-317, whereby CONTRACTOR agreed to provide Rural Mental Health Triage Services (Rural Triage Services) in East and West rural Fresno County cities; and WHEREAS, the parties desire to amend COUNTY Agreement No. 15-317, regarding changes as stated below and restate the Agreement in its entirety. NOW, THEREFORE, for good and valuable consideration, the receipt and adequacy of which is hereby acknowledged, the parties agree to amend the Agreement as follows: 1.That the following be added to existing COUNTY Agreement No. 15-317, Section Two (2)“TERM”, as set forth in the original Agreement, at Page Three (3), Line Two (2) after the number “2018”: “The term of this Agreement shall be extended for an additional twelve (12) month period beginning July 1, 2020 and shall terminate on June 30, 2021.” 2.That the existing COUNTY Agreement No. 15-317, Section Four (4) “COMPENSATION”, as set forth in the original Agreement, Page Four (4), beginning with Line Six (6), with the word “The” and ending on Page Six (6), Line Twenty-Six (26) with the number “($0.00)” be deleted and the following inserted in its place: “4. COMPENSATION The maximum compensation amount under this Agreement for Rural Triage Services in East Fresno County and West Fresno County combined for the period July 14, 2015 through June 30, 2021, shall not exceed Fourteen Million, Eight Hundred Sixty-Three Thousand, Five Agreement No. 15-317-2 28th April COUNTY OF FRESNO Fresno, CA -2 - 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 Hundred Fifteen and No/100 Dollars ($14,863,515.00). East Fresno County The maximum compensation amount under this Agreement for East Fresno County Rural Triage Services for the period July 14, 2015 through June 30, 2021, for all funding and revenue streams collectively shall not exceed Eight Million, One Hundred Fifty-Four Thousand, Eight Hundred Ninety and No/100 Dollars ($8,154,890.00). The maximum compensation amount under this Agreement for East Fresno County Rural Triage Services for the period of July 14, 2015 through June 30, 2016, shall not exceed One Million, Three Hundred Thousand, Four Hundred Thirty-One and No/100 Dollars ($1,300,431.00). The maximum amount of SB 82 funding under this Agreement during said time period shall not exceed Eight Hundred, Forty-Nine Thousand, Six Hundred Fifty-Three and No/100 Dollars ($849,653.00). In addition, it is understood by CONTRACTOR and COUNTY that CONTRACTOR estimates to generate Four Hundred Fifty Thousand, Seven Hundred Seventy-Eight and No/100 Dollars ($450,778.00) in Medi-Cal Federal Financial Participation (FFP) to offset CONTRACTOR’s program costs. The maximum compensation amount under this Agreement for East Fresno County Rural Triage Services for the period of July 1, 2016 through June 30, 2017, shall not exceed One Million, Two Hundred Eighty-Eight Thousand, One Hundred Twenty-Four and No/100 Dollars ($1,288,124.00). The maximum amount of SB 82 funding under this Agreement during said time period shall not exceed Eight Hundred Forty-Two Thousand, One Hundred Twenty-Two and No/100 Dollars ($842,122.00). In addition, it is understood by CONTRACTOR and COUNTY that CONTRACTOR estimates to generate Four Hundred Forty-Six Thousand, Two and No/100 Dollars ($446,002.00) in Medi-Cal FFP to offset CONTRACTOR’s program costs. The maximum compensation amount under this Agreement for East Fresno County Rural Triage Services for the period of July 1, 2017 through June 30, 2018, shall not exceed One Million, Three Hundred Twenty-Seven Thousand, Three Hundred Twenty-Two and No/100 Dollars ($1,327,322.00). The maximum amount of SB 82 funding under this Agreement for said time period shall not exceed Eight Hundred Sixty-Seven Thousand, One Hundred Sixty-Eight and No/100 Dollars COUNTY OF FRESNO Fresno, CA -3 - 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 ($867,168.00). In addition, it is understood by CONTRACTOR and COUNTY that CONTRACTOR estimates to generate Four Hundred Sixty Thousand, One Hundred Fifty-Four and No/100 Dollars ($460,154.00) in Medi-Cal FFP to offset CONTRACTOR’s program costs. The maximum compensation amount under this Agreement for East Fresno County Rural Triage Services for the period of July 1, 2018 through June 30, 2019, shall not exceed One Million, Three Hundred Seventy-Five Thousand, Nine Hundred Fifty-Two and No/100 Dollars ($1,375,952.00). In addition, it is understood by CONTRACTOR and COUNTY that CONTRACTOR estimates to generate Three Hundred Thousand, Three Hundred Sixty and No/100 Dollars ($300,360.00) in Medi-Cal FFP to offset CONTRACTOR’s program costs. The maximum compensation amount under this Agreement for East Fresno County Rural Triage Services for the period of July 1, 2019 through June 30, 2020, shall not exceed One Million, Four Hundred Ten Thousand, Three Hundred Seventy-Five and No/100 Dollars ($1,410,375.00). In addition, it is understood by CONTRACTOR and COUNTY that CONTRACTOR estimates to generate Three Hundred Thousand, Three Hundred Sixty and No/100 Dollars ($300,360.00) in Medi-Cal FFP to offset CONTRACTOR’s program costs. The maximum compensation amount under this Agreement for East Fresno County Rural Triage Services for the period of July 1, 2020 through June 30, 2021, shall not exceed One Million Four Hundred Fifty-Two Thousand, Six Hundred Eighty-Six and No/100 Dollars ($1,452,686.00). In addition, it is understood by CONTRACTOR and COUNTY that CONTRACTOR estimates to generate Four Hundred Eighty-Two Thousand, Eight Hundred Eighty-One and No/100 Dollars ($482,881.00) in Medi-Cal FFP to offset CONTRACTOR’s program costs. West Fresno County The maximum compensation amount under this Agreement for West Fresno County Rural Triage Services for the period October 1, 2015 through June 30, 2021, shall not exceed Six Million, Seven Hundred Eight Thousand, Six Hundred Twenty-Five and No/100 Dollars ($6,708,625.00). The maximum compensation amount under this Agreement for West Fresno County Rural Triage Services for the period of October 1, 2015 through June 30, 2016, shall not exceed Nine COUNTY OF FRESNO Fresno, CA -4 - 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 Hundred Eight Thousand, Four Hundred Twenty and No/100 Dollars ($908,420.00). The maximum amount of Public Safety Realignment funding under this Agreement for said time period shall not exceed Thirty-Three Thousand, Seven Hundred Thirty-Two and No/100 Dollars ($33,732.00). The maximum amount of Mental Health Services Act (MHSA) funding under this Agreement for said time period shall not exceed Five Hundred Fourteen Thousand, Seven Hundred Twenty-One and No/100 Dollars ($514,721.00). In addition, it is understood by CONTRACTOR and COUNTY that CONTRACTOR estimates to generate Three Hundred Fifty-Nine Thousand, Nine Hundred Sixty- Seven and No/100 Dollars ($359,967.00) in Medi-Cal FFP in this term to offset CONTRACTOR’s program costs. The maximum compensation amount under this Agreement for West Fresno County Rural Triage Services for the period of July 1, 2016 through June 30, 2017, shall not exceed One Million, Eighty-Nine Thousand, Five Hundred Fifty and No/100 Dollars ($1,089,550.00). The maximum amount of MHSA funding under this Agreement for said time period shall not exceed Six Hundred Forty-Three Thousand, Five Hundred Forty-Eight and No/100 Dollars ($643,548.00). In addition, it is understood by CONTRACTOR and COUNTY that CONTRACTOR estimates to generate Four Hundred Forty-Six Thousand, Two and No/100 Dollars ($446,002.00) in Medi-Cal FFP in this term to offset CONTRACTOR’s program costs. The maximum compensation amount under this Agreement for West Fresno County Rural Triage Services for the period of July 1, 2017 through June 30, 2018, shall not exceed One Million, One Hundred Twenty-Two Thousand, Seven Hundred Ninety-One and No/100 Dollars ($1,122,791.00). The maximum amount of MHSA funding under this Agreement in this term shall not exceed Six Hundred Sixty-Two Thousand, Six Hundred Thirty-Seven and No/100 Dollars ($662,637.00). In addition, it is understood by CONTRACTOR and COUNTY that CONTRACTOR estimates to generate Four Hundred Sixty Thousand, One Hundred Fifty-Four and No/100 Dollars ($460,154.00) in Medi-Cal FFP for said time period to offset CONTRACTOR’s program costs. The maximum compensation amount under this Agreement for West Fresno County Rural Triage Services for the period of July 1, 2018 through June 30, 2019, shall not exceed One Million, One Hundred Sixty-Five Thousand, Two Hundred Eighty-Six and No/100 Dollars COUNTY OF FRESNO Fresno, CA -5 - 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 ($1,165,286.00). In addition, it is understood by CONTRACTOR and COUNTY that CONTRACTOR estimates to generate One Hundred Nine Thousand, Eight Hundred Ninety-Five and No/100 Dollars ($109,895.00) in Medi-Cal FFP to offset CONTRACTOR’s program costs. The maximum compensation amount under this Agreement for West Fresno County Rural Triage Services for the period of July 1, 2019 through June 30, 2020, shall not exceed One Million, One Hundred Ninety-Three Thousand, Three Hundred Eighty-Eight and No/100 Dollars ($1,193,388.00). In addition, it is understood by CONTRACTOR and COUNTY that CONTRACTOR estimates to generate One Hundred Nine Thousand, Eight Hundred Ninety-Five and No/100 Dollars ($109,895.00) in Medi-Cal FFP to offset CONTRACTOR’s program costs. The maximum compensation amount under this Agreement for West Fresno County Rural Triage Services for the period of July 1, 2020 through June 30, 2021, shall not exceed One Million, Two Hundred Twenty-Nine Thousand, One Hundred Eighty-Nine and No/100 Dollars ($1,229,189.00). In addition, it is understood by CONTRACTOR and COUNTY that CONTRACTOR estimates to generate One Hundred Eighty-Three Thousand, Five Hundred Sixty-Seven and No/100 Dollars ($183,567.00) in Medi-Cal FFP to offset CONTRACTOR’s program costs.” 2.That, effective July 1, 2020, all references in existing COUNTY Agreement No. 15-317 to “Revised Exhibit C ‘East’” and “Revised Exhibit C ‘West’” shall be changed to read “Revised Exhibit C and C-1 ‘East’” and “Revised Exhibit C and C-1 ‘West’”, respectively. 3. Revised Exhibit C-1 “East” and Revised Exhibit C-1 “West” are attached hereto and incorporated herein by reference. 4.That the existing COUNTY Agreement No. 15-317, Section Seven (7) “MODIFICATION”, as set forth in the original Agreement, Page Fourteen (14), beginning with Line Nine (9), with the word “Notwithstanding” and ending on Page Fourteen (14), Line Sixteen (16) with the word “herein” be deleted and the following inserted in its place: “7. MODIFICATION Notwithstanding the above, changes to services, staffing and responsibilities of the CONTRACTOR, as needed, to accommodate changes in the laws relating to mental health and substance use disorder treatment, as set forth in Exhibit A, may be made with the signed written COUNTY OF FRESNO Fresno, CA -6 - 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 approval of COUNTY’s DBH Director, or designee, and CONTRACTOR through an amendment approved by COUNTY’s County Counsel and the COUNTY’s Auditor-Controller/Treasurer-Tax Collector’s Office. In addition, changes to expense category (i.e., Salary & Benefits, Facilities/Equipment, Operating, Financial Services, Special Expenses, Fixed Assets, etc.) subtotals in the budgets, and changes to the volume of units of services/types of service units to be provided, as set forth in Revised Exhibit C and C-1 “East” and Revised Exhibit C and C-1 “West”, that do not exceed ten percent (10%) of the maximum compensation payable to the CONTRACTOR may be made with the written approval of COUNTY’s DBH Director, or designee. Changes to the expense categories in the budgets that exceed ten percent (10%) of the maximum compensation payable to the CONTRACTOR may be made with the signed written approval of COUNTY’s DBH Director, or designee, through an amendment approved by COUNTY’s Counsel and COUNTY’s Auditor- Controller/Treasurer-Tax Collector’s Office. Said modifications shall not result in any change to the maximum compensation amounts payable to CONTRACTOR, as stated in this Agreement.” 5.COUNTY and CONTRACTOR agree that this Amendment II is sufficient to amend the Agreement; and that upon execution of this Amendment II, the Agreement, Amendment I and Amendment II together shall be considered the Agreement. The Agreement, as hereby amended, is ratified and continued. All provisions, terms, covenants, conditions and promises contained in the Agreement, and not amended herein, shall remain in full force and effect. /// /// /// /// /// /// /// ,. '. ,, !I- l ·1 l i .! ,'i -<-I 1 ~ j .·, rj l :; 6 I ~1 II 1 0 IN WITNESS WHEREOF, the paroes here!o ~ axea.lled this .Amendrnem ii to COUNTY Agreement No. ~5-317 as of the day and year first ~ ie.~. Print Name: _Amanda Nugent Dimne __ Title: __ Chief Executive Officer __ _ Ct\aim1,an of ~d. ~ President, or any Vice President COONTYOFFRESNO Ernest Btrd'rl'( l\-~rr s . Charrman of ~e Boom of Supervisoi"S of ttie County of Fresno ATTEST. J J ! ::11::6~ BE.Rl\!!ICE IE . SEIDEL C!!em to She Boa,d1 of &.YpetVlSOO-S ~ty _of Fresoo, Stare of Ca'iitomia i4 l 5 , ... lD j ~ .. _, 1 ;~ 2. l ), ~: ~') ~·. :' -~ 24 ., c· ,,_ \.' I Tille: ........,.~_Chief Financial C>fficef" __ Secretary (of Corporation), or any Assistant Secretary, or Chief Financial Officer. or any Assistant Treasurer Mailing Address.: l(cngs V~· Behawx~ Heol& 7170 J\lofth Ftnaneral Avenue .. Su~ t il<D Fresno. CA 93720 FOR ACCOUNTING PURPOSES O"N!LV : FundJS1!>c:las.t;: 0001J1·00DO Account..'Program : 7295ffi OrganiZation: 56304766 East 56~767 ·~ FY 2015-16: Sl.300.431 Fv w~&-rr·. s:2.:rrr .674 FY 2017-rn : S2.450.113 FY 2018-19:: S2.~-1.238 FY 2019--20~ S2.603. T63 FY 2020-21: $2,681,876 TOTAL; $14,863,515 EAST $1.300.431 S 1. .'2138.f."24- S L327 .322 :s~ .. 375 .. 952 51.410.315 $1,452.686 WESl s S-08 .4...?G qg mo..rMs) '£f..OO~.~ 51 .122 ,79~ $1,165.286 51i .193,3SS S~.229,1$? Revised Exhibit C-1 Page 1 of 14 Employee Salaries Acct #Position FTE Admin Direct Total 1101 Program Oversight 0.27 -$ 33,553$ 33,553$ 1102 Clinical Supervisor 0.55 58,779 58,779 1103 Program Manager 0.55 - 71,523 71,523 1104 Clinician (2 unlicensed, 5 Licensed)7.00 - 641,516 641,516 1105 Per Diem Team Responders (Licensed)0.45 - 37,137 37,137 1106 Program Staff Accountant 0.11 - 5,967 5,967 1107 Administrative Support 0.40 - 19,427 19,427 1108 - - 1109 - - - 1110 - - - 1111 - - - 1112 - - - 1113 - - - 1114 - - - 1115 - - - 1116 - - - 1117 - - - 1118 - - - 1119 - - - 1120 - - - Personnel Salaries Subtotal 9.33 -$ 867,902$ 867,902$ Employee Benefits Acct #Admin Direct Total 1201 -$ 15,364$ 15,364$ 1202 - 25,883 25,883 1203 - 111,259 111,259 1204 - - - 1205 - - - 1206 - - - -$ 152,506$ 152,506$ Payroll Taxes & Expenses: Acct #Admin Direct Total 1301 -$ -$ -$ 1302 - 66,395 66,395 1303 - 6,509 6,509 1304 - - - 1305 - - - 1306 - - - -$ 72,904$ 72,904$ -$ 1,093,312$ 1,093,312$ Employee Benefits Subtotal: Description 1000: SALARIES & BENEFITS Retirement Worker's Compensation Health Insurance Other (Specify) Other (Specify) OASDI FICA/MEDICARE SUI PROGRAM EXPENSES Other (Specify) Other (Specify) EMPLOYEE SALARIES & BENEFITS TOTAL: Other (Specify) Other (Specify) Rural Mental Health Triage - East Kings View Corporation Fiscal Year (FY 2020-21) Description Payroll Taxes & Expenses Subtotal: Fresno County Department of Behavioral Health Contract Budget Template Revised 2/7/2020 Revised Exhibit C-1 Page 2 of 14 2000: CLIENT SUPPORT Acct #Amount 2001 -$ 2002 - 2003 - 2004 - 2005 - 2006 - 2007 - 2008 - 2009 - 2010 - 2011 - 2012 - 2013 - 2014 - 2015 - 2016 - -$ 3000: OPERATING EXPENSES Acct #Amount 3001 10,200$ 3002 1,847 3003 10,350 3004 - 3005 6,500 3006 3,500 3007 - 3008 27,200 3009 150 3010 650 3011 - 3012 - 60,397$ 4000: FACILITIES & EQUIPMENT Acct #Amount 4001 9,500$ 4002 26,500 4003 3,526 4004 25,400 4005 - 4006 6,650 4007 - 4008 - 4009 - 4010 - 71,576$ 5000: SPECIAL EXPENSES Staff Mileage Subscriptions & Memberships Clothing, Food, & Hygiene Other (Specify) Other (Specify) Office, Household & Program Supplies Utility Vouchers Program Supplies - Medical Medication Supports Household Items for Clients Employment Support Other (Specify) Other (Staff Recuitment/Background Checks) Other (Specify) Other (Specify) Telecommunications Printing/Postage FACILITIES/EQUIPMENT TOTAL: OPERATING EXPENSES TOTAL: Other (Specify) Advertising Rent/Lease Building Building Maintenance Education Support Other (Miscellaneous) Staff Development & Training Child Care Rent/Lease Vehicles Client Transportation & Support Client Housing Support Other (Specify) Other (Specify) Security Utilities Rent/Lease Equipment Other (Specify) Other (Specify) Other (Specify) Other (Specify) Vehicle Maintenance Line Item Description Line Item Description Line Item Description DIRECT CLIENT CARE TOTAL Fresno County Department of Behavioral Health Contract Budget Template Revised 2/7/2020 Revised Exhibit C-1 Page 3 of 14 Acct #Amount 5001 38,118$ 5002 - 5003 - 5004 100 5005 8,577 5006 - 5007 - 5008 - 46,795$ 6000: ADMINISTRATIVE EXPENSES Acct #Amount 6001 143,960$ 6002 6,940 6003 - 6004 - 6005 18,500 6006 - 6007 - 6008 - 6009 - 6010 - 6011 - 6012 - 169,400$ 7000: FIXED ASSETS Acct #Amount 7001 7,706$ 7002 500 7003 3,000 7004 - 7005 - 7006 - 7007 - 7008 - 11,206$ Payroll Services Computer Equipment & Software Copiers, Cell Phones, Tablets, Devices to Contain HIPAA Data Furniture & Fixtures Leasehold/Tenant/Building Improvements Insurance (Liability): Other (Specify) Other Assets over $500 with Lifespan of 2 Years + Consultant (Network & Data Management) 1,452,686$ TOTAL PROGRAM EXPENSES FIXED ASSETS EXPENSES TOTAL ADMINISTRATIVE EXPENSES TOTAL SPECIAL EXPENSES TOTAL: Depreciation (Provider-Owned Equipment to be Used for Program Purposes) External Audit Professional Liability Insurance Accounting/Bookkeeping Line Item Description Contractual/Consulting Services (Specify) Translation Services Administrative Overhead Other (Avatar License Fee) Other (Specify) Other (Specify) Other (Specify) HMIS (Health Management Information System) Line Item Description Other (Specify) Other (Specify) Other (Specify) Other (Specify) Assets over $5,000/unit (Specify) Other (Specify) Other (Specify) Line Item Description Fresno County Department of Behavioral Health Contract Budget Template Revised 2/7/2020 Revised Exhibit C-1 Page 4 of 14 Acct #Service Units Rate Amount 8001 Mental Health Services 25,000 3.26 81,498$ 8002 Case Management 32,474 2.50 81,184 8003 Crisis Services 225,000 5.00 1,125,000 8004 Medication Support 0 - - 8005 Collateral 0 - - 8006 Plan Development 0 - - 8007 Assessment 0 - - 8008 Rehabilitation 0 - - 282,473 1,287,682$ 75% 965,762 50%482,881 482,881$ Acct #Amount 8101 Drug Medi-Cal -$ 8102 SABG -$ -$ Acct #Amount 8201 Realignment -$ -$ Acct #MHSA Component Amount 8301 CSS - Community Services & Supports 8302 PEI - Prevention & Early Intervention 969,805 8303 INN - Innovations - 8304 WET - Workforce Education & Training - 8305 CFTN - Capital Facilities & Technology - 969,805$ Acct #Amount 8401 Client Fees -$ 8402 Client Insurance - 8403 - 8404 - 8405 - -$ 8200 - REALIGNMENT NET PROGRAM COST: PROGRAM FUNDING SOURCES TOTAL PROGRAM FUNDING SOURCES:1,452,686$ 0$ SUBSTANCE USE DISORDER FUNDS TOTAL MEDI-CAL FFP TOTAL MHSA TOTAL Line Item Description Line Item Description 8100 - SUBSTANCE USE DISORDER FUNDS OTHER REVENUE TOTAL Line Item Description 8400 - OTHER REVENUE Grants (Specify) Other (Specify) Other (Specify) 8000 - SHORT/DOYLE MEDI-CAL (FEDERAL FINANCIAL PARTICIPATION) Estimated Specialty Mental Health Services Billing Totals: Estimated % of Clients who are Medi-Cal Beneficiaries Estimated Total Cost of Specialty Mental Health Services Provided to Medi-Cal Beneficiaries Federal Financial Participation (FFP) % MHSA Program Name 8300 - MENTAL HEALTH SERVICE ACT (MHSA) Line Item Description REALIGNMENT TOTAL Fresno County Department of Behavioral Health Contract Budget Template Revised 2/7/2020 Revised Exhibit C-1 Page 5 of 14 Budget Narrative ACCT #LINE ITEM AMT DETAILED DESCRIPTION OF ITEMS BUDGETED IN EACH ACCOUNT LINE 1000: SALARIES & BENEFITS 1,093,312 Employee Salaries 867,902 1101 Program Oversight 33,553 Positions will provide agency specific staff oversight and represent and maintain the collaborative relationship between agencies. Provide program management and direction. Ensures operations are running smoothly and in compliance with contract requirements. 1102 Clinical Supervisor 58,779 Provides supervision of all licenced and unlicensed clinical staff. 1103 Program Manager 71,523 Provides supervision of all staff and direct oversight of program management. 1104 Clinician (2 unlicensed, 5 Licensed)641,516 Assist with managing the client's illness and reduce its impact on the client's life, and referrals to appropriate linkages. 1105 Per Diem Team Responders (Licensed)37,137 Per Diem-Assist with managing the client's illness and reduce its impact on the client's life, and referrals to appropriate linkages. 1106 Program Staff Accountant 5,967 Provides budget guidance, monthly invoicing and other fiscal services. 1107 Administrative Support 19,427 Provides administrative support for the program and assist with medical billing and records. 1108 0 - 1109 0 - 1110 0 - 1111 0 - 1112 0 - 1113 0 - 1114 0 - 1115 0 - 1116 0 - 1117 0 - 1118 0 - 1119 0 - 1120 0 - Employee Benefits 152,506 1201 Retirement 15,364 Cost of 401K 1202 Worker's Compensation 25,883 Workers Comp Insurance 1203 Health Insurance 111,259 Cost of Medical, Vision, Dental, Life and Long Term Disability Insurance 1204 Other (Specify)- 1205 Other (Specify)- 1206 Other (Specify)- Payroll Taxes & Expenses:72,904 1301 OASDI - 1302 FICA/MEDICARE 66,395 Cost of FICA/Medicare 1303 SUI 6,509 Cost of SUI 1304 Other (Specify)- 1305 Other (Specify)- 1306 Other (Specify)- 2000: CLIENT SUPPORT - 2001 Child Care - 2002 Client Housing Support - 2003 Client Transportation & Support - 2004 Clothing, Food, & Hygiene - 2005 Education Support - 2006 Employment Support - 2007 Household Items for Clients - 2008 Medication Supports - 2009 Program Supplies - Medical - 2010 Utility Vouchers - 2011 Other (Specify)- 2012 Other (Specify)- 2013 Other (Specify)- Kings View Corporation Rural Mental Health Triage - East Fiscal Year (FY 2020-21) Fresno County Department of Behavioral Health Contract Budget Narrative Revised 2/7/2020 Revised Exhibit C-1 Page 6 of 14 ACCT #LINE ITEM AMT DETAILED DESCRIPTION OF ITEMS BUDGETED IN EACH ACCOUNT LINE 2014 Other (Specify)- 2015 Other (Specify)- 2016 Other (Specify)- 3000: OPERATING EXPENSES 60,397 3001 Telecommunications 10,200 Cost of telephone services, cell phones service, data connectivity. 3002 Printing/Postage 1,847 Aniticapting courier services and postage nesessary for program. Business cards and other special printing in bulk that is less cost effective to outsource rather than utilization of a copier. 3003 Office, Household & Program Supplies 10,350 Includes all supplies used by staff in the course of providing services. 3004 Advertising - 3005 Staff Development & Training 6,500 Cost of continuation of staff development and training. 3006 Staff Mileage 3,500 Reimbusements to staff for personal vehicle use when lease vehicle not available and require to provide services or other program needs, paid at IRS rate. Any travel transporation fees, such as parking fees. 3007 Subscriptions & Memberships - 3008 Vehicle Maintenance 27,200 Auto repairs & maintenance required to maintain leased vehicles for client transporation and program needs, such as oil changes and car washes. Yearly cost of GPS, vehicle tracking service. 3009 Other (Miscellaneous)150 Anticipating minor expense that would not fall under any other category. 3010 Other (Staff Recuitment/Background Checks)650 Thorough background checks and drug testing. 3011 Other (Specify)- 3012 Other (Specify)- 4000: FACILITIES & EQUIPMENT 71,576 4001 Building Maintenance 9,500 Copier maintenance, inspection services, pest control, alarm services, janitorial services and minor building repairs and maintenance. 4002 Rent/Lease Building 26,500 Building space lease. 4003 Rent/Lease Equipment 3,526 Copier lease and water dispenser rental. 4004 Rent/Lease Vehicles 25,400 The cost of lease vehicles to assist with program and client needs. 4005 Security - 4006 Utilities 6,650 The cost of gas and electric. 4007 Other (Specify)- 4008 Other (Specify)- 4009 Other (Specify)- 4010 Other (Specify)- 5000: SPECIAL EXPENSES 46,795 5001 Consultant (Network & Data Management)38,118 Kings View Information Technology Department (KVIT) will provide hardware and software support for successful data collection. A database will be designed for this program. KVIT will procure equipment, software & other services from approved & authorized vendors. Provide online, onsite, or phone-based emergency support- 24/7 from the KVIT Help Desk. 5002 HMIS (Health Management Information System) - 5003 Contractual/Consulting Services (Specify)- 5004 Translation Services 100 Anticipating need of outsource transaltion services. 5005 Other (Avatar License Fee)8,577 Estimated cost of Avatar fees. 5006 Other (Specify)- 5007 Other (Specify)- 5008 Other (Specify)- 6000: ADMINISTRATIVE EXPENSES 169,400 6001 Administrative Overhead 143,960 Expenses provides program management, fiscal services, payroll, human resources, accounts payable and other administrative functions. 6002 Professional Liability Insurance 6,940 Cost general and professional liablity insurance. 6003 Accounting/Bookkeeping - 6004 External Audit - 6005 Insurance (Liability):18,500 Cost of personal property, accidental and auto insurance. 6006 Payroll Services - Fresno County Department of Behavioral Health Contract Budget Narrative Revised 2/7/2020 Revised Exhibit C-1 Page 7 of 14 ACCT #LINE ITEM AMT DETAILED DESCRIPTION OF ITEMS BUDGETED IN EACH ACCOUNT LINE 6007 Depreciation (Provider-Owned Equipment to be Used for Program Purposes) - 6008 Other (Specify)- 6009 Other (Specify)- 6010 Other (Specify)- 6011 Other (Specify)- 6012 Other (Specify)- 7000: FIXED ASSETS 11,206 7001 Computer Equipment & Software 7,706 Anitipating additional computer equipment needed for new staff and or replacement. Duo factor licensing and other computer software. 7002 Copiers, Cell Phones, Tablets, Devices to Contain HIPAA Data 500 Anticipating additional equipment cost for new staff and or replacement. 7003 Furniture & Fixtures 3,000 Anticipating additional furniture cost for new staff and or replacement. 7004 Leasehold/Tenant/Building Improvements - 7005 Other Assets over $500 with Lifespan of 2 Years + - 7006 Assets over $5,000/unit (Specify)- 7007 Other (Specify)- 7008 Other (Specify)- TOTAL PROGRAM EXPENSE FROM BUDGET NARRATIVE:1,452,686 TOTAL PROGRAM EXPENSES FROM BUDGET TEMPLATE:1,452,686 - Fresno County Department of Behavioral Health Contract Budget Narrative Revised 2/7/2020 Revised Exhibit C-1 Page 8 of 14 Employee Salaries Acct #Position FTE Admin Direct Total 1101 Program Oversight 0.23 -$ 27,387$ 27,387$ 1102 Clinical Supervisor 0.45 48,092 48,092 1103 Program Manager 0.45 - 58,519 58,519 1104 Clinician (2 Licensed, 5 Unlicensed) 7.00 - 555,944 555,944 1105 Per Diem Team Responders (Licensed)0.38 - 32,919 32,919 1106 Program Staff Accountant 0.09 - 4,842 4,842 1107 Administrative Support 0.26 - 12,628 12,628 1108 - - 1109 - - - 1110 - - - 1111 - - - 1112 - - - 1113 - - - 1114 - - - 1115 - - - 1116 - - - 1117 - - - 1118 - - - 1119 - - - 1120 - - - Personnel Salaries Subtotal 8.86 -$ 740,331$ 740,331$ Employee Benefits Acct #Admin Direct Total 1201 -$ 13,083$ 13,083$ 1202 - 22,078 22,078 1203 - 94,739 94,739 1204 - - - 1205 - - - 1206 - - - -$ 129,900$ 129,900$ Payroll Taxes & Expenses: Acct #Admin Direct Total 1301 -$ -$ -$ 1302 - 56,635 56,635 1303 - 5,553 5,553 1304 - - - 1305 - - - 1306 - - - -$ 62,188$ 62,188$ -$ 932,419$ 932,419$ Rural Mental Health Triage- West Kings View Corporation Fiscal Year (FY 2020-21) Description Payroll Taxes & Expenses Subtotal: Other (Specify) Other (Specify) EMPLOYEE SALARIES & BENEFITS TOTAL: Other (Specify) Other (Specify) PROGRAM EXPENSES 1000: SALARIES & BENEFITS Retirement Worker's Compensation Health Insurance Other (Specify) Other (Specify) OASDI FICA/MEDICARE SUI Employee Benefits Subtotal: Description Fresno County Department of Behavioral Health Contract Budget Template Revised 2/7/2020 Revised Exhibit C-1 Page 9 of 14 2000: CLIENT SUPPORT Acct #Amount 2001 -$ 2002 - 2003 - 2004 - 2005 - 2006 - 2007 - 2008 - 2009 - 2010 - 2011 - 2012 - 2013 - 2014 - 2015 - 2016 - -$ 3000: OPERATING EXPENSES Acct #Amount 3001 9,591$ 3002 1,500 3003 6,500 3004 - 3005 5,000 3006 1,600 3007 - 3008 20,218 3009 150 3010 450 3011 - 3012 - 45,009$ 4000: FACILITIES & EQUIPMENT Acct #Amount 4001 8,000$ 4002 23,000 4003 2,200 4004 23,176 4005 - 4006 4,800 4007 - 4008 - 4009 - 4010 - 61,176$ 5000: SPECIAL EXPENSES Security Utilities Rent/Lease Equipment Other (Specify) Other (Specify) Other (Specify) Other (Specify) Vehicle Maintenance Line Item Description Line Item Description Line Item Description DIRECT CLIENT CARE TOTAL Other (Specify) Advertising Rent/Lease Building Building Maintenance Education Support Other (Miscellaneous) Staff Development & Training Child Care Rent/Lease Vehicles Client Transportation & Support Client Housing Support Other (Specify) Other (Specify) FACILITIES/EQUIPMENT TOTAL: OPERATING EXPENSES TOTAL: Other (Staff Recuitment/Background Checks) Other (Specify) Other (Specify) Telecommunications Printing/Postage Staff Mileage Subscriptions & Memberships Clothing, Food, & Hygiene Other (Specify) Other (Specify) Office, Household & Program Supplies Utility Vouchers Program Supplies - Medical Medication Supports Household Items for Clients Employment Support Other (Specify) Fresno County Department of Behavioral Health Contract Budget Template Revised 2/7/2020 Revised Exhibit C-1 Page 10 of 14 Acct #Amount 5001 32,400$ 5002 - 5003 - 5004 100 5005 8,577 5006 - 5007 - 5008 - 41,077$ 6000: ADMINISTRATIVE EXPENSES Acct #Amount 6001 116,801$ 6002 5,940 6003 - 6004 - 6005 17,500 6006 - 6007 - 6008 - 6009 - 6010 - 6011 - 6012 - 140,241$ 7000: FIXED ASSETS Acct #Amount 7001 7,768$ 7002 500 7003 1,000 7004 - 7005 - 7006 - 7007 - 7008 - 9,268$ Other (Specify) Other (Specify) Other (Specify) Other (Specify) Assets over $5,000/unit (Specify) Other (Specify) Other (Specify) Line Item Description Administrative Overhead Other (Avatar License Fee) Other (Specify) Other (Specify) Other (Specify) HMIS (Health Management Information System) Line Item Description Professional Liability Insurance Accounting/Bookkeeping Line Item Description Contractual/Consulting Services (Specify) Translation Services 1,229,190$ TOTAL PROGRAM EXPENSES FIXED ASSETS EXPENSES TOTAL ADMINISTRATIVE EXPENSES TOTAL SPECIAL EXPENSES TOTAL: Depreciation (Provider-Owned Equipment to be Used for Program Purposes) External Audit Computer Equipment & Software Copiers, Cell Phones, Tablets, Devices to Contain HIPAA Data Furniture & Fixtures Leasehold/Tenant/Building Improvements Insurance (Liability): Other (Specify) Other Assets over $500 with Lifespan of 2 Years + Consultant (Network & Data Management) Payroll Services Fresno County Department of Behavioral Health Contract Budget Template Revised 2/7/2020 Revised Exhibit C-1 Page 11 of 14 Acct #Service Units Rate Amount 8001 Mental Health Services 15,955 3.26 52,013$ 8002 Case Management 15,000 2.50 37,500 8003 Crisis Services 80,000 5.00 400,000 8004 Medication Support 0 - - 8005 Collateral 0 - - 8006 Plan Development 0 - - 8007 Assessment 0 - - 8008 Rehabilitation 0 - - 110,955 489,513$ 75% 367,135 50%183,567 183,567$ Acct #Amount 8101 Drug Medi-Cal -$ 8102 SABG -$ -$ Acct #Amount 8201 Realignment -$ -$ Acct #MHSA Component Amount 8301 CSS - Community Services & Supports -$ 8302 PEI - Prevention & Early Intervention 1,045,623 8303 INN - Innovations - 8304 WET - Workforce Education & Training - 8305 CFTN - Capital Facilities & Technology - 1,045,623$ Acct #Amount 8401 Client Fees -$ 8402 Client Insurance - 8403 - 8404 - 8405 - -$ Grants (Specify) Other (Specify) Other (Specify) 8000 - SHORT/DOYLE MEDI-CAL (FEDERAL FINANCIAL PARTICIPATION) Estimated Specialty Mental Health Services Billing Totals: Estimated % of Clients who are Medi-Cal Beneficiaries Estimated Total Cost of Specialty Mental Health Services Provided to Medi-Cal Beneficiaries Federal Financial Participation (FFP) % MHSA Program Name 8300 - MENTAL HEALTH SERVICE ACT (MHSA) Line Item Description REALIGNMENT TOTAL NET PROGRAM COST: PROGRAM FUNDING SOURCES TOTAL PROGRAM FUNDING SOURCES:1,229,190$ (0)$ SUBSTANCE USE DISORDER FUNDS TOTAL MEDI-CAL FFP TOTAL MHSA TOTAL Line Item Description Line Item Description 8100 - SUBSTANCE USE DISORDER FUNDS OTHER REVENUE TOTAL Line Item Description 8400 - OTHER REVENUE 8200 - REALIGNMENT Fresno County Department of Behavioral Health Contract Budget Template Revised 2/7/2020 Revised Exhibit C-1 Page 12 of 14 Budget Narrative ACCT #LINE ITEM AMT DETAILED DESCRIPTION OF ITEMS BUDGETED IN EACH ACCOUNT LINE 1000: SALARIES & BENEFITS 932,419 Employee Salaries 740,331 1101 Program Oversight 27,387 Positions will provide agency specific staff oversight and represent and maintain the collaborative relationship between agencies. Provide program management and direction. Ensures operations are running smoothly and in compliance with contract requirements. 1102 Clinical Supervisor 48,092 Provides supervision of all licenced and unlicensed clinical staff. 1103 Program Manager 58,519 Provides supervision of all staff and direct oversight of program management. 1104 Clinician (2 Licensed, 5 Unlicensed) 555,944 Assist with managing the client's illness and reduce its impact on the client's life, and referrals to appropriate linkages. 1105 Per Diem Team Responders (Licensed)32,919 Per Diem-Assist with managing the client's illness and reduce its impact on the client's life, and referrals to appropriate linkages. 1106 Program Staff Accountant 4,842 Provides budget guidance, monthly invoicing and other fiscal services. 1107 Administrative Support 12,628 Provides administrative support for the program and assist with medical billing and records. 1108 0 - 1109 0 - 1110 0 - 1111 0 - 1112 0 - 1113 0 - 1114 0 - 1115 0 - 1116 0 - 1117 0 - 1118 0 - 1119 0 - 1120 0 - Employee Benefits 129,900 1201 Retirement 13,083 Cost of 401K 1202 Worker's Compensation 22,078 Workers Comp Insurance 1203 Health Insurance 94,739 Cost of Medical, Vision, Dental, Life and Long Term Disability Insurance 1204 Other (Specify)- 1205 Other (Specify)- 1206 Other (Specify)- Payroll Taxes & Expenses:62,188 1301 OASDI - 1302 FICA/MEDICARE 56,635 Cost of FICA/Medicare 1303 SUI 5,553 Cost of SUI 1304 Other (Specify)- 1305 Other (Specify)- 1306 Other (Specify)- 2000: CLIENT SUPPORT - 2001 Child Care - 2002 Client Housing Support - 2003 Client Transportation & Support - 2004 Clothing, Food, & Hygiene - 2005 Education Support - 2006 Employment Support - 2007 Household Items for Clients - 2008 Medication Supports - 2009 Program Supplies - Medical - 2010 Utility Vouchers - 2011 Other (Specify)- 2012 Other (Specify)- 2013 Other (Specify)- Kings View Corporation Rural Mental Health Triage- West Fiscal Year (FY 2020-21) Fresno County Department of Behavioral Health Contract Budget Narrative Revised 2/7/2020 Revised Exhibit C-1 Page 13 of 14 ACCT #LINE ITEM AMT DETAILED DESCRIPTION OF ITEMS BUDGETED IN EACH ACCOUNT LINE 2014 Other (Specify)- 2015 Other (Specify)- 2016 Other (Specify)- 3000: OPERATING EXPENSES 45,009 3001 Telecommunications 9,591 Cost of telephone services, cell phones service, data connectivity. 3002 Printing/Postage 1,500 Aniticapting courier services and postage nesessary for program. Business cards and other special printing in bulk that is less cost effective to outsource rather than utilization of a copier. 3003 Office, Household & Program Supplies 6,500 Includes all supplies used by staff in the course of providing services. 3004 Advertising - 3005 Staff Development & Training 5,000 Cost of continuation of staff development and training. 3006 Staff Mileage 1,600 Reimbusements to staff for personal vehicle use when lease vehicle not available and require to provide services or other program needs, paid at IRS rate. Any travel transporation fees, such as parking fees. 3007 Subscriptions & Memberships - 3008 Vehicle Maintenance 20,218 Auto repairs & maintenance required to maintain leased vehicles for client transporation and program needs, such as oil changes and car washes. Yearly cost of GPS, vehicle tracking service. 3009 Other (Miscellaneous)150 Anticipating minor expense that would not fall under any other category. 3010 Other (Staff Recuitment/Background Checks)450 Thorough background checks and drug testing. 3011 Other (Specify)- 3012 Other (Specify)- 4000: FACILITIES & EQUIPMENT 61,176 4001 Building Maintenance 8,000 Copier maintenance, inspection services, pest control, alarm services, janitorial services and minor building repairs and maintenance. 4002 Rent/Lease Building 23,000 Building space lease. 4003 Rent/Lease Equipment 2,200 Copier lease and water dispenser rental. 4004 Rent/Lease Vehicles 23,176 The cost of lease vehicles to assist with program and client needs. 4005 Security - 4006 Utilities 4,800 The cost of gas and electric. 4007 Other (Specify)- 4008 Other (Specify)- 4009 Other (Specify)- 4010 Other (Specify)- 5000: SPECIAL EXPENSES 41,077 5001 Consultant (Network & Data Management)32,400 Kings View Information Technology Department (KVIT) will provide hardware and software support for successful data collection. A database will be designed for this program. KVIT will procure equipment, software & other services from approved & authorized vendors. Provide online, onsite, or phone-based emergency support- 24/7 from the KVIT Help Desk. 5002 HMIS (Health Management Information System) - 5003 Contractual/Consulting Services (Specify)- 5004 Translation Services 100 Anticipating need of outsource transaltion services. 5005 Other (Avatar License Fee)8,577 Estimated cost of Avatar fees. 5006 Other (Specify)- 5007 Other (Specify)- 5008 Other (Specify)- 6000: ADMINISTRATIVE EXPENSES 140,241 6001 Administrative Overhead 116,801 Expenses provides program management, fiscal services, payroll, human resources, accounts payable and other administrative functions. 6002 Professional Liability Insurance 5,940 Cost general and professional liablity insurance. 6003 Accounting/Bookkeeping - 6004 External Audit - 6005 Insurance (Liability):17,500 Cost of personal property, accidental and auto insurance. 6006 Payroll Services - Fresno County Department of Behavioral Health Contract Budget Narrative Revised 2/7/2020 Revised Exhibit C-1 Page 14 of 14 ACCT #LINE ITEM AMT DETAILED DESCRIPTION OF ITEMS BUDGETED IN EACH ACCOUNT LINE 6007 Depreciation (Provider-Owned Equipment to be Used for Program Purposes) - 6008 Other (Specify)- 6009 Other (Specify)- 6010 Other (Specify)- 6011 Other (Specify)- 6012 Other (Specify)- 7000: FIXED ASSETS 9,268 7001 Computer Equipment & Software 7,768 Anitipating additional computer equipment needed for new staff and or replacement. Duo factor licensing and other computer software. 7002 Copiers, Cell Phones, Tablets, Devices to Contain HIPAA Data 500 Anticipating additional equipment cost for new staff and or replacement. 7003 Furniture & Fixtures 1,000 Anticipating additional furniture cost for new staff and or replacement. 7004 Leasehold/Tenant/Building Improvements - 7005 Other Assets over $500 with Lifespan of 2 Years + - 7006 Assets over $5,000/unit (Specify)- 7007 Other (Specify)- 7008 Other (Specify)- TOTAL PROGRAM EXPENSE FROM BUDGET NARRATIVE:1,229,190 TOTAL PROGRAM EXPENSES FROM BUDGET TEMPLATE:1,229,190 - Fresno County Department of Behavioral Health Contract Budget Narrative Revised 2/7/2020